Following an investigation by the California Department of Insurance (CDI) Criminal Investigations Branch’s Fraud Division, Todd Owen Balcom was arrested at his residence in Port Hueneme pursuant to an arrest warrant issued by Ventura County Superior Court.
Balcom, 51, was charged by the Ventura County District Attorney’s Office with four felony counts of workers’ compensation insurance fraud. If convicted, Balcom could be sentenced up to five years in state prison and/or a $50,000 fine.
On Nov. 10, 2000, while employed at the Foundation for Retarded Citizens of Ventura County, Balcom suffered work-related injuries to his right hand, elbow and wrist. Majestic Insurance, the workers’ compensation insurance carrier for the Foundation for the Retarded Citizens of Ventura County, accepted Balcom’s claim and initiated Temporary Total Disability benefits. Balcom was being treated for his alleged injuries by an orthopedic surgeon.
After receiving information that Balcom was possibly working or that he was self-employed, Majestic Insurance requested surveillance. On April 27 and 28, 2001, Luchay & Associates Investigations videotaped Balcom reportedly performing work as a disc jockey at Wagon Wheel Bowl in Oxnard. It was confirmed with the general manager at Wagon Wheel Bowl that Balcom had been working as a disc jockey every weekend for over a year.
Balcom allegedly never disclosed to Majestic Insurance about his disc jockey activities and earnings. Balcom reportedly collected a total of $9,908.61 in Temporary Total Disability and $6,300 in earnings. Had the insurance carrier known that Balcom was working and earning money, they would have paid Balcom $120 every two weeks rather than $480.
As a result of Balcom’s reported material concealment, Majestic Insurance over paid $3,600 in Temporary Total Disability benefits.
Topics California Fraud Workers' Compensation
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